STRESS MANAGEMENT

Stress management refers to the wide spectrum of techniques and psychotherapies aimed at controlling a person's levels of stress, especially chronic stress, usually for the purpose of improving everyday functioning. In this context, the term 'stress' refers only to a stress with significant negative consequences, or distress in the terminology advocated by Hans Selye, rather than what he calls eustress, a stress whose consequences are helpful or otherwise positive. Stress produces numerous symptoms which vary according to persons, situations, and severity. These can include physical health decline as well as depression. The process of stress management is named as one of the keys to a happy and successful life in modern society. Although life provides numerous demands that can prove difficult to handle, stress management provides a number of ways to manage anxiety and maintain overall well-being. Despite stress often being thought of as a subjective experience, levels of stress are readily measureable using various physiological tests, similar to those used in polygraphs. Many practical stress management techniques are available, some for use by health practitioners and others for self-help, which may help an individual to reduce stress, provide positive feelings of being in control of one's life and promote general well-being. The effectiveness of the different stress management techniques can be difficult to assess, as few of them have received significant attention from researchers. Consequently, the amount and quality of evidence for the various techniques varies widely. Some are accepted as effective treatments for use in psychotherapy, whilst others with less evidence favoring them are considered alternative therapies. Many professional organizations exist to promote and provide training in conventional or alternative therapies. There are several models of stress management, each with distinctive explanations of mechanisms for controlling stress. Much more research is necessary to provide a better understanding of which mechanisms actually operate and are effective in practice. Historical foundations Walter Cannon and Hans Selye used animal studies to establish the earliest scientific basis for the study of stress. They measured the physiological responses of animals to external pressures, such as heat and cold, prolonged restraint, and surgical procedures, and then extrapolated from these studies to human beings.

Subsequent studies of stress in humans by Richard Rahe and others established the view that stress is caused by distinct, measureable life stressors, and further, that these life stressors can be ranked by the median degree of stress they produce (leading to the Holmes and Rahe Stress Scale). Thus, stress was traditionally conceptualized to be a result of external insults beyond the control of those experiencing the stress. More recently, however, it has been argued that external circumstances do not have any intrinsic capacity to produce stress, but instead their effect is mediated by the individual's perceptions, capacities, and understanding. Models Transactional model Richard Lazarus and Susan Folkman suggested in 1984 that stress can be thought of as resulting from an imbalance between demands and resources or as occurring when pressure exceeds one's perceived ability to cope. Stress management was developed and premised on the idea that stress is not a direct response to a stressor but rather one's resources and ability to cope mediate the stress response and are amenable to change, thus allowing stress to be controllable. Among the many stressors mentioned by employees, these are the most common: The way employees are treated by their bosses/supervisors or company Lack of job security Company policies Coworkers who don't do their fair share Unclear expectations Poor communication Not enough control over assignments Inadequate pay or benefits Urgent deadlines Too much work Long hours Uncomfortable physical conditions Relationship conflicts Coworkers making careless mistakes Dealing with rude customers Lack of cooperation How the company treats coworkers

In order to develop an effective stress management programme it is first necessary to identify the factors that are central to a person controlling his/her stress, and to identify the intervention methods which effectively target these factors. Lazarus and Folkman's interpretation of stress focuses on the transaction between people and their external environment (known as the Transactional Model). The model contends that stress may not be a stressor if the person does

not perceive the stressor as a threat but rather as positive or even challenging. Also, if the person possesses or can use adequate coping skills, then stress may not actually be a result or develop because of the stressor. The model proposes that people can be taught to manage their stress and cope with their stressors. They may learn to change their perspective of the stressor and provide them with the ability and confidence to improve their lives and handle all of types of stressors. Health realization/innate health model The health realization/innate health model of stress is also founded on the idea that stress does not necessarily follow the presence of a potential stressor. Instead of focusing on the individual's appraisal of so-called stressors in relation to his or her own coping skills (as the transactional model does), the health realization model focuses on the nature of thought, stating that it is ultimately a person's thought processes that determine the response to potentially stressful external circumstances. In this model, stress results from appraising oneself and one's circumstances through a mental filter of insecurity and negativity, whereas a feeling of wellbeing results from approaching the world with a "quiet mind". This model proposes that helping stressed individuals understand the nature of thought especially providing them with the ability to recognize when they are in the grip of insecure thinking, disengage from it, and access natural positive feelingswill reduce their stress. Types of stress Acute stress Acute stress is the most common form of stress among humans worldwide. Acute stress deals with the pressures of the near future or dealing with the very recent past. This type of stress is often misinterpreted for being a negative connotation. While this is the case in some circumstances, it is also a good thing to have some acute stress in life. Running or any other form of exercise is considered an acute stressor. Some exciting or exhilarating experiences such as riding a roller coaster is an acute stress but is usually very fun. Acute stress is a short term stress and in result, does not have enough time to do the damage that long term stress causes. Chronic stress Chronic stress is the exact opposite of acute stress. It has a wearing effect on people that can become a very serious health risk if it continues over a long period of time. Chronic stress can lead to memory loss, damage spacial recognition and produce a decreased drive of eating. The severity varies from person to person and also sex difference can be an underlying factor. Women are able to take longer durations of stress than men without showing the same maladaptive changes. Men can deal with shorter stress duration better than women can but once males hit a certain threshold, the chances of them developing mental issues increases drastically.

Stress in the workplace Stress in the workplace is a commonality throughout the world in every business. Managing that stress becomes vital in order to keep up job performance as well as relationship with co-workers and employers. For some workers, changing the work environment relieves work stress. Making the environment less competitive between employees decreases some amounts of stress. However, each person is different and some people like the pressure to perform better. Salary can be an important concern of employees. Salary can affect the way people work because they can aim for promotion and in result, a higher salary. This can lead to chronic stress. Cultural differences have also shown to have some major effects on stress coping problems. Eastern Asian employees may deal with certain work situations differently from how a Western North American employee would. In order to manage stress in the workplace, employers can provide stress managing programs such as therapy, communication programs, and a more flexible work schedule. Medical Environment Stress A study was done on the stress levels in general practitioners and hospital consultants in 1994. Over 500 medical employees participated in this study done by Dr. R.P Caplan. These results showed that 47% of the workers scored high on their questionnaire for high levels of stress. 27% of the general practitioners even scored to be very depressed. These numbers came to a surprise to Dr. Caplan and it showed how alarming the large number of medical workers becomes stressed out because of their jobs. Managers stress levels were not as high as the actual practitioners themselves. An eye opening statistic showed that nearly 54% of workers suffered from anxiety while being in the hospital. Although this was a small sample size for hospitals around the world, Caplan feels this trend is probably fairly accurate across the majority of hospitals. EFFECTS OF STRESS ON HEALTH AND PERFORMANCE Stress is proven beyond doubt to make people ill, and evidence is increasing as to number of ailments and diseases caused by stress. Stress is now known to contribute to heart disease; it causes hypertension and high blood pressure, and impairs the immune system. Stress is also linked to strokes, IBS (irritable bowel syndrome), ulcers, diabetes, muscle and joint pain, miscarriage during pregnancy, allergies, alopecia and even premature tooth loss. Various US studies have demonstrated that removing stress improves specific aspects of health: stress management was shown to be capable of reducing the risk of heart attack by up to 75% in people with heart disease; stress management techniques, along with methods for coping with

anger, contributed to a reduction of high blood pressure, and; for chronic tension headache sufferers it was found that stress management techniques increased the effectiveness of prescribed drugs, and after six months actually equaled the effectiveness of anti-depressants. The clear implication for these ailments is that stress makes them worse. Stress significantly reduces brain functions such as memory, concentration, and learning, all of which are central to effective performance at work. Certain tests have shown up to 50% loss of performance in cognitive tests performed by stress sufferers. Some health effects caused by stress are reversible and the body and mind reverts to normal when the stress is relieved. Other health effects caused by stress are so serious that they are irreversible, and at worse are terminal. Stress is said by some to be a good thing, for themselves or others, that it promotes excitement and positive feelings. If these are the effects then it's not stress as defined here. It's the excitement and stimulus derived (by one who wants these feelings and can handle them) from working hard in a controlled and manageable way towards an achievable and realistic aim, which for sure can be very exciting, but it ain't stress. Stress is bad for people and organizations, it's a threat and a health risk, and it needs to be recognized and dealt with, not dismissed as something good, or welcomed as a badge of machismo - you might as well stick pins in your eyes. Measuring stress Levels of stress can be measured. One way is through the use of psychological testing: the Holmes and Rahe Stress Scale is used to rate stressful life events, while the DASS contains a scale for stress based on self-report items. Changes in blood pressure and galvanic skin response can also be measured to test stress levels, and changes in stress levels. A digital thermometer can be used to evaluate changes in skin temperature, which can indicate activation of the fight-orflight response drawing blood away from the extremities. Cortisol is the main hormone released during a stress response and measuring cortisol from hair will give a 60-90 baseline stress level of an individual. This method of measuring stress is currently the most popular method in the clinic. Stress Management Programs in Workplace Many businesses today have begun to use Stress Management Programs for employees who are having trouble adapting to stress at the workplace or at home. Many people have spill over stress from home into their working environment. There are a couple of ways businesses today try to alleviate stress on their employees. One way is individual intervention. This starts off by monitoring the stressors in the individual. After monitoring what causes the stress, next is attacking that stressor and trying to figure out ways to alleviate them in any way. Developing social support is vital in individual intervention, being with others to help you cope has proven to be a very effective way to avoid stress. Avoiding the stressors all together is the best possible way to get rid of stress but that is very difficult to do in the workplace. Changing behavioral patterns, May in turn, help reduce some of the stress that is put on at work as well.

Employee Assistance Programs can include in-house counseling programs on managing stress. Evaluative research has been conducted on EAPs that teach individual stress control and inoculation techniques such as relaxation, biofeedback, and cognitive restructuring. Studies show that these programs can reduce the level of physiological arousal associated with high stress. Participants who master behavioral and cognitive stress-relief techniques report less tension, fewer sleep disturbances, and an improved ability to cope with workplace stressors. Another way of reducing stress at work is by simply changing the workload for an employee. Some may be too overwhelmed that they have so much work to get done, or some also may have such little work that they are not sure what to do with themselves at work. Improving communications between employees also sounds like a simple approach, but it is very effective for helping reduce stress. Sometimes making the employee feel like they are a bigger part of the company, such as giving them a voice in bigger situations shows that you trust them and value their opinion. Having all the employees mesh well together is a very underlying factor which can take away much of workplace stress. If employees fit well together and feed off of each other, the chances of lots of stress are very minimal. Lastly, changing the physical qualities of the workplace may reduce stress. Changing simple things such as the lighting, air temperature, odor, and up to date technology. Intervention is broken down into three steps: Primary, Secondary, and Tertiary. Primary deals with eliminating the stressors all together. Secondary deals with detecting stress and figuring out ways to cope with it and improving stress management skills. Finally, tertiary deals with recovery and rehabbing the stress all together. These three steps are usually the most effective way to deal with stress not just in the workplace, but overall. Techniques High demand levels load the person with extra effort and work. A new time schedule is worked up, and until the period of abnormally high, personal demand has passed, the normal frequency and duration of former schedules is limited. Many techniques cope with the stresses life brings. Some of the following ways induce a lower than usual stress level, temporarily, to compensate the biological tissues involved; others face the stressor at a higher level of abstraction: Autogenic training Social activity Cognitive therapy Conflict resolution Cranial release technique Getting a hobby Meditation Mindfulness (psychology)

Deep breathing Yoga Nidra Nootropics Reading novels Prayer Relaxation techniques Artistic expression Fractional relaxation Physical exercise Progressive relaxation Spas Somatic training Spending time in nature Stress balls Natural medicine Clinically validated alternative treatments Time management Planning and decision making Listening to certain types of relaxing music Spending quality time with pets

Techniques of stress management will vary according to the philosophical paradigm. Stress prevention & resilience Although many techniques have traditionally been developed to deal with the consequences of stress considerable research has also been conducted on the prevention of stress, a subject closely related to psychological resilience-building. A number of self-help approaches to stressprevention and resilience-building have been developed, drawing mainly on the theory and practice of cognitive-behavioral therapy. Effectiveness of stress management Stress management has physiological and immune benefits. Positive outcomes are observed using a combination of non-drug interventions Treatment of anger or hostility, Autogenic training Talking therapy (around relationship or existential issues) Biofeedback

Cognitive therapy for anxiety or clinical depression INTERNATIONAL PERSPECTIVE An international review of stress prevention in the workplace highlights that there has been a lack of systematic Stress Risk Assessment (Kompier and Cooper, 1999). The UK Health and Safety Executive (HSE) Guidance recommends that a risk assessment approach be followed when tackling work-related stress. Increased anger and loss of humor amongst people in the workplace are just two of the knock-on effects that businesses now have to deal with due to poor workplace health, according to new research (published April 2006).The 'Quality of Working Life' report published by the Chartered Management Institute and Workplace Health Connect uncovers a high number of physical and psychological symptoms and highlights the impact these have on business performance. The survey questioned 1,541 managers in the UK revealing a poor picture of health, with only half (50%) believing they are currently in 'good' health. Key findings of the report were: Anger and mood: 43% admitted to feeling or becoming angry with others too easily and one third (31%) confessed to a loss of humor creating workplace pressures. Muscle tension and headaches: More than half of those questioned (55%) complained of muscular tension or physical aches and pains. 44% said they experienced frequent headaches. Tiredness and insomnia: Asked about psychological symptoms, 55% experienced feelings of constant tiredness at work. 57% complained of insomnia. The report also shows that ill-health is having an impact on morale and performance. One-third (30%) admit they are irritable 'sometimes or often' towards colleagues. Some managers also want to avoid contact with other people (26%) and many (21%) have difficulty making decisions due to ill health. Mary Chapman (no relation), chief executive of the Chartered Management Institute, says: "With the impact of ill-health being keenly felt in the workplace, managers need a better understanding of the consequences of letting relatively minor symptoms escalate. They need to take more personal responsibility for improving their health because inaction is clearly having an effect on colleagues and the knock-on effect is that customer relationships will suffer, too." Elizabeth Gyngell, programme director at Workplace Health Connect, says: "Health activities should not be driven by a concern over legislation, but by the understanding that improved well-being can generate significant benefits to morale and performance. This means organizations should ensure their employees are well versed in identifying and addressing symptoms before they escalate."

STRESS MANAGEMENT TOOLS AT ORGANISATION First one is STRESS RISK ASSESSMENT which is a preventive measure taken by organization management to prevent work related stress in organization. The second one is HEALTH AND SAFETY EXECUTIVE HEALTH AND SAFTEY EXECUTIVE (HSE) The UKs Health & Safety Executive has guidelines for employers to help them understand and meet their legal obligations. The HSEs stress Management Standards set out a structure that employers can follow, showing how to risk-assess a company for stress, and how to tackle any problems identified as needing action. The Standards look at several areas: i. ii. iii. iv. v. vi. the demands made on employees; the level of control employees have over their work; the support employees receive from managers and colleagues; the clarity of an employee's role within the organization; the nature of relationships at work; And the way that changes is managed.

The Standards are designed to build a structure that lets employers take care of stress at work. They let you easily identify current performance, judge how this differs from benchmark standards, and develop solutions to close the gap The Health & Safety Executive Stress Management Standards (Note on the Management Standards) The descriptions in each of the standards shown as What should be happening/states to be achieved define a desirable set of conditions to work towards. You can use the data from the HSE indicator and analysis tools to define the gap between where you are now and where you want to get to. The analysis tool will provide a set of data on your performance on each of the six standard areas. Also provided are representative data on current performance in the UK workforce. You will probably find that you are good on some things and less good on others. Together with any existing data you may have (for example, on sickness absence or staff turnover), this information can be used in focus group discussions with employees To determine what is happening locally and what should be done to close the gap. Demands Includes issues like workload, work patterns, and the work environment The standard is that:

 Employees indicate that they are able to cope with the demands of their jobs; and Systems are in place locally to respond to any individual concerns. What should be happening / states to be achieved: The organization provides employees with adequate and achievable demands in relation to the agreed hours of work Peoples skills and abilities are matched to the job demands; Jobs are designed to be within the capabilities of employees; and Employees concerns about their work environment are addressed.

Control How much say the person has in the way they do their work The standard is that: Employees indicate that they are able to have a say about the way they do their work; and Systems are in place locally to respond to any individual concerns. What should be happening / states to be achieved: Where possible, employees have control over their pace of work; Employees are encouraged to use their skills and initiative to do their work; Where possible, employees are encouraged to develop new skills to help them undertake new and challenging pieces of work; The organization encourages employees to develop their skills; Employees have a say over when breaks can be taken; and Employees are consulted over their work patterns.

Support Includes the encouragement, sponsorship and resources provided by the organization, line management and colleagues The standard is that:

 Employees indicate that they receive adequate information and support from their colleagues and superiors; and Systems are in place locally to respond to any individual concerns. What should be happening / states to be achieved: The organization has policies and procedures to adequately support employees; Systems are in place to enable and encourage managers to support their staff Systems are in place to enable and encourage employees to support their colleagues; Employees know what support is available and how and when to access it; Employees know how to access the required resources to do their job; and Employees receive regular and constructive feedback.

Relationship Includes promoting positive working to avoid conflict and dealing with unacceptable behavior The standard is that: Employees indicate that they are not subjected to unacceptable behaviors, e.g. bullying at work; and Systems are in place locally to respond to any individual concerns. What should be happening / states to be achieved: The organization promotes positive behaviors at work to avoid conflict and ensure fairness; Employees share information relevant to their work; The organization has agreed policies and procedures to prevent or resolve unacceptable behavior; Systems are in place to enable and encourage managers to deal with unacceptable behavior; and Systems are in place to enable and encourage employees to report unacceptable behavior.

Role Whether people understand their role within the organization and whether the organization ensures that the person does not have conflicting roles The standard is that: Employees indicate that they understand their role and responsibilities; and Systems are in place locally to respond to any individual concerns. What should be happening / states to be achieved: The organization ensures that, as far as possible, the different requirements it places upon employees are compatible; The organization provides information to enable employees to understand their role and responsibilities; The organization ensures that, as far as possible, the requirements it places upon employees are clear; and Systems are in place to enable employees to raise concerns about any uncertainties or conflicts they have in Their role and responsibilities.

Change How organizational change (large or small) is managed and communicated in the organization The standard is that: Employees indicate that the organization engages them frequently when undergoing an organizational change; and Systems are in place locally to respond to any individual concerns. What should be happening / states to be achieved: The organization provides employees with timely information to enable them to understand the reasons for proposed changes; The organization ensures adequate employee consultation on changes and provides opportunities for employees to influence proposals;

Where possible, employees are encouraged to develop new skills to help them undertake new and challenging pieces of work; Employees are aware of the probable impact of any changes to their jobs. If necessary, employees are given training to support any changes in their jobs; Employees are aware of timetables for changes; Employees have access to relevant support during changes

STRESS RISK ASSESSMENT This determines The levels of stress Main sources of work related stress Steps to be taken to prevent stress in work place There are 3 types of SRA they are: o Task based SRA o Team based SRA o Future focused SRA TASK BASED SRA This identifies the stressors and hazardous situations to human efforts that arise from complex and unusual situations. This is to be included in pre risk assessment. This links stress and safety TEAM BASED SRA This identifies stress in teams that do similar work in organization and finds local solutions to them using employee involvement, this is very important in light of changes in HSE act 2002. FUTURE FOCUSED SRA Identifies stress in employees from future projects, tasks, organizational changes and planning changes. This also involves employees for solution. The stress risk assessment is considered by the organizations as the most effective stress management technique because it gives importance to source rather than symptoms.it is a proactive measure.

THE INDIAN SENARIO In NPL Chennai there different stress management techniques used at work place, Stress management training is often presented in corporate training programs by non-psychologists. While some of these programs are informational, they usually do not help one to make the life changes needed to reduce stress substantially. They at Jayakartha have proficient trained psychologists and acclaimed Yoga therapists combine relaxation skill training, cognitive therapy techniques based on Neuro Linguistic Programming and Yoga to assist individuals in managing their lives more effectively, and therefore reducing life stress considerably. NLP therapy techniques help to reexamine the importance of life stressors and to manage the outcome of stressful events better. Yoga blends itself as a traditional method of relaxing the physiological self and allows replenishment of the mind, body and soul. This comprehensive psychological and physiological approach to stress management results in significant life management changes and reduced stress symptoms. This will be achieved by: Identifying sources of stress Set goals to achieve specific targets - chunking long time goals Develop deep levels of rapport to establish relationships of trust and enjoy quality relationship with people Be motivated and stay motivated Understanding the Meta Model Anchoring Peace and relaxations Yoga exercises to lower and relax the physical self

Even though many organizations like NPL are using stress management techniques still a survey by INTERNATIONAL STRESS MANAGEMENT ASSOCIATION, INDIA says that 90% of corporate employees feel stress every day at work. This can be eliminated through fine relationships between management and employees. CONCLUSION So stress can be managed through commitment of management and employees and awareness in both and also some of the tools and techniques mentioned above. However only good relationships can solve such complex issues. Because: STRESS MANAGEMENT = GOOD MANAGEMENT AND GOOD MANAGEMENT=STRESS MANAGEMENT